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Treatment can help addicts regain lives

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The Dispatch.

I respond to the
New York Times article “Addiction treatment with a dark side” in the Nov. 17
Dispatch. I am the president of the Ohio chapter of the American Society of Addiction
Medicine, which represents a group of physicians dedicated to increasing access to and improving
the quality of addiction treatment. We also want to educate the public that addiction is a real
medical disease, not just a problem of weak individuals who have no willpower.

Individuals with addictions undoubtedly are ripe fruit for unscrupulous providers to charge
large amounts of cash in the name of treatment. There are simply not enough programs to provide
quality services for addictions. Additionally, many insurance companies limit payments for such
services, and uninsured patients have nowhere else to turn but fly-by-night Suboxone clinics.

Most addiction physicians believe that buprenorphine (Suboxone) is a powerful tool in the
package of treatments. Before buprenorphine, the only way an opiate addict could receive
medication-assisted treatment was to go daily to a methadone clinic. I believe most of the article’s
claims of dangers were exaggerated. Those of us who use buprenorphine in our practices are amazed
how relatively quickly some individuals can return to work or school once the medication is
started.

For addicts injecting opiates, this medicine greatly decreases their chances of contracting
Hepatitis C and HIV. Only a few children have been poisoned with buprenorphine, and this was when
tablets were much more common. Now, most physicians use the films, which are securely packaged
individually.

Most illegal use of buprenorphine is actually for its appropriate use, which is to remove the
pains of opiate withdrawal and craving in between using their drug of choice. It is very rare that
individuals use buprenorphine to get high, as there are cheaper and stronger alternatives readily
available, including prescription opiates and heroin.

Importantly, buprenorphine is not total treatment for opiate addiction. Behavioral treatment and
counseling are necessary for individuals to relearn how to recognize triggers and to find new ways
to deal with the stresses of everyday life. Any physician who is giving this medicine without also
doing regular urine drug screening and requiring behavioral therapy should be avoided. For that
matter, any physician who is not accepting insurance for these services should be avoided.

There are other ways for patients to ensure they are seeing a reputable provider. For one,
physicians can be certified through professional agencies, such as the American Board of Addiction
Medicine and the American Academy of Addiction Psychiatry and my own American Society of Addiction
Medicine. All of these agencies have Web pages where patients can search for certified addiction
physicians in their community.

Until society recognizes that addiction is a chronic relapsing brain disease that requires
serious ongoing medical and behavioral treatment, many addicts will turn to inappropriate therapies
that will cost them significant amounts of money with little chance of recovery.